Much of the news in 2023 was dominated by the disdain of public health workers, in particular nurses and doctors, with their job satisfaction and remuneration. The cardiac physiology workforce also has its issues. This is reflected by the lack of recruitment and retention that has resulted in a projected shortfall of 760 new physiologists needed to meet demand over the next 10 years¹ .


Lack of training opportunities, poor morale, unsustainable levels of staffing and lack of flexible working arrangements are just a few of the reasons why cardiac physiologists are leaving the NHS in search of roles within the private sector or even leaving the profession altogether. Are independent sector healthcare providers, like ECG On-Demand compounding the problem by luring away this scarce resource?


Depending on the structure of the department, Holter analysis is often given less priority to more acute services. Cardiac physiologists are not always given uninterrupted time to report on analysis and efficiency suffers.


As a company, ECG On-Demand is able to increase daily productivity using a more efficient workflow and Holter analysis technology. A cardiac physiologist at ECG On-Demand is able to analyse twice as many Holters than they would have done in the NHS.


Given that there is a finite number of cardiac physiologists available across both the NHS and independent sectors, we would argue that we are able to free up cardiac physiologists so they can be deployed to other services such as echocardiography which also has a large burden on cardiac departments across the country.


To illustrate this, the cost to deliver a 24hr Holter monitoring session in the NHS has been estimated to cost a department £159² as per the most recent figures published in 2021/22. The NHS payment scheme for ECG monitoring (EY51Z) quotes a reimbursement rate of £134 for the 2023/25 period³. ECG On-Demand Direct-to-patient service is able to deliver 7 days of Holter at less than tariff and 24hr of Holter monitoring at substantially less. 

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In an ideal world , services like ECG On-Demand would not exist and all testing would be conducted with the NHS, however, this is not the world we live in. We like to see our service as an extension of the NHS rather than a competitor. Whilst we employ ex- NHS physiologists we are able to use them in a more efficient way and sell their time and expertise back at less cost to the NHS than if they were directly employed.